Does perimenopause cause irregular periods?

During perimenopause, the ovaries may not release an egg in every cycle or may do so at different times. This can change the interval between periods, the amount of bleeding, and how long bleeding lasts. Some cycles may be skipped, followed by a heavier bleed.

Irregular periods can have other explanations, including pregnancy, thyroid problems, polycystic ovary syndrome, stress, weight change, medicines, or uterine conditions. A changing pattern should be considered alongside age, symptoms, contraception, and pregnancy possibility.

Use a calendar or app to record bleeding days, flow, clots, pelvic pain, and symptoms between periods. Arrange a review if the change persists, affects daily life, or follows a long gap. A clinician may recommend testing or examination to rule out pregnancy, anaemia, thyroid problems, or a uterine cause.

Seek urgent care for very heavy bleeding with dizziness, faintness, severe weakness, or severe pelvic pain. Get prompt advice for bleeding after menopause, bleeding during pregnancy, bleeding after sex, or a pattern that repeatedly leaves you exhausted. These situations need assessment rather than being attributed to hormone change alone.

Ask whether your cycle pattern fits perimenopause, whether pregnancy or other conditions should be checked, and which options can regulate or reduce bleeding. Discuss contraception too, because ovulation can still occur during perimenopause.